The differentiation between nociception and pain is often ignored. Pain emerges from the brain according to apparent danger to body tissues. Nociception is the neural processes of processing noxious stimuli (mechanical, thermal or chemical changes above a certain threshold) that have the potential to damage tissue.
Increased central sensitization is an (mal)adaptation that occurs when the body experience persisted pain. This optimizes the likelihood of tissue healing and minimize the risk of secondary injury in the beginning. Over time, sensitization may lose its value and become a problem of its own (chronic pain). Changes on cortical level occur. Certain strategies can treat people with central sensitization due to the plasticity of the brain. The main strategy within CLBP-patients is the cognitive and behavioral strategies:
- Reduce feelings of helplessness and uncontrollability (establish a sense of control over pain)
- Change pain coping strategies
- Attention to activity planning and pacing
- Give education about pain and the factors that modulate it
> from Moseley et al.; Neurorehabilitation and Neural Repair 26 (2012) 646-652. All rights reserved to the American Society of Neurorehabilitation.
Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.
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